DRUG ABUSE TREATMENT EMERGENCY DEPARTMENT LINKAGES

描述：（申请人？s摘要） 有复杂问题的药物滥用者经常接触医疗紧急情况 部门急诊科可以帮助患者接触药物滥用 治疗并与不太紧急的护理联系起来。这项随机试验将测试 两种联系策略的效果：（1）过渡性病例管理;（2） 美沙酮免费治疗券-含阿片类依赖注射药物 从公立全科医院急诊部招募的用户。的 主要目的是测试干预措施对以下方面的影响：（1）入学 （2）参与药物滥用治疗;（3）参与医疗和 社会服务;（3）改善阿片类药物使用的结果;（4）改变 参与者？急性卫生服务的利用模式。 参与者将是在一个 以医院为基础的急诊科，两两随机分配 析因设计接收：（1）过渡性病例管理，（2） 免费美沙酮治疗，（3）病例管理和代金券，或（4）常规护理 （简短的联系和推荐）。案例管理将有一个认知行为 专心点评估将在随机化前进行，随访评估将在 6、12和18个月。主要假设将检验以下因素的影响：（1）代金券 （2）药物滥用治疗登记的个案管理; （3）凭证与个案管理相结合， 阿片类药物的使用;和（4）对使用的医疗保健费用的个案管理 参与者为了确定参与和保留的预测因素，该研究 将收集有关治疗过程的信息， 可以在其他设置中使用的手册。 治疗研究工作将评估与医疗保健联系在一起的创新模式 进行药物滥用治疗它有助于跨组成部分的真相与和解委员会研究， 包括自我推荐与Batki医生的凭证推荐，尼古丁 依赖与霍尔博士，和测量的过程变量与博士。 哈瓦西它还有助于真相与和解委员会所述的合作研究 包括药物滥用治疗和统计分析、精神病和 药物滥用合并症，并评估阿片类药物滥用者的环境。

DESCRIPTION: (Applicant?s Abstract) Drug abusers with complex problems have frequent contact with medical emergency departments. Emergency departments can assist patients in accessing drug abuse treatment and linking with less acute care. This randomized trial will test the effects of two linkage strategies: (1) transitional case management; and (2) vouchers for free methadone treatment --- with opioid-dependent injection drug users recruited from the emergency department of a public general hospital. The primary aims are to test the effects of the interventions on: (1) enrolling participants in drug abuse treatment; (2) enrolling participants in medical and social services; (3) improving opioid use outcomes; and (4) changing participants? pattern of utilization of acute health services. Participants will be opioid-dependent injection drug users recruited at a hospital-based emergency department, randomly assigned in a two-by-two factorial design to receive: (1) transitional case management, (2) vouchers for free methadone treatment, (3) case management and vouchers, or (4) usual care (brief contact and referral). Case management will have a cognitive behavioral focus. Assessments will occur before randomization and follow-up assessments at 6, 12 and 18 months. Primary hypotheses will test the effects of: (1) vouchers on enrollment in drug abuse treatment; (2) case management on enrollment in other services; (3) the combination of vouchers and case management in reducing opioid use; and (4) case management on the cost of health care used by the participants. To identify predictors of participation and retention, the study will gather information about the treatment process and prepare treatment manuals that can be used in other settings. The treatment research effort will assess innovative models linking health care with drug abuse treatment. It contributes to cross-component TRC studies, including self-referral versus voucher-referral with Dr. Batki, nicotine dependence with Dr. Hall, and measurement of process variables with Dr. Havassy. It also contributes to collaborative studies described in the TRC core, including drug abuse treatment and statistical analyses, psychiatric and substance abuse comorbidity, and assessing the environments of opioid abusers.